低剂量内吗啡用于剖腹产后止痛,并计划多模式疼痛治疗方案:一个前性,随机的,开放的盲目的终点研究
K H Hatter1, N W Shugart1, N Paladugu1
1Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, Charleston, SC, United States of America.
International journal of obstetric anesthesia
|April 6, 2025
概括
对于剖腹产后的疼痛管理,较低剂量的内吗啡 (50微克) 与较高剂量 (100微克) 相同有效,当与凯托洛拉克和乙氨基相结合时,在缓解疼痛或副作用方面没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 在剖腹产后使用内吗啡和多模式止痛药进行最佳的疼痛管理需要剂量优化.
- 之前的研究还没有明确确定理想的甲状腺内吗啡剂量,以尽量减少副作用,同时最大限度地缓解疼痛.
研究的目的:
- 为了比较两种不同剂量 (50微克 vs. 100微克) 的静脉内吗啡的疗效和安全性,结合多模式止痛治疗,用于剖腹产后疼痛管理.
- 为了确定较低的静脉内吗啡剂量是否与较高剂量相比,在提供足够的疼痛控制和减少阿片类药物救援需求方面不劣.
主要方法:
- 一项前性,随机化,开放盲目的终点研究,涉及201名接受剖腹产的参与者.
- 参与者接受了入口布皮瓦卡因,芬太尼和50微克或100微克的入口吗啡,随后是预定的静脉注射凯托洛拉克和口服乙氨基.
- 主要结局是24小时内获得首次阿片类药物救援剂量的时间,使用非劣势测试进行分析.
主要成果:
- 在50μg (23.5小时) 和100μg (22.9小时) 内吗啡组之间,第一个救援止痛剂剂的中位时间与50μg (23.5小时) 和100μg (22.9小时) 内吗啡组相似.
- 在需要阿片类药物救援剂量的概率,术后,恶心,吐,阿片类药物的总消耗或疼痛得分方面,没有观察到群体之间的显著差异.
- 在两个治疗手臂之间,第一次行走的时间和行走期间的疼痛也是可比的.
结论:
- 当与凯索洛拉克和乙氨基结合用于剖腹产后的疼痛缓解时,以首次阿片类药物救援剂量时间为基础,50微克的静脉内吗啡不低于100微克.
- 与较高剂量相比,较低的静脉内吗啡剂量有效地控制疼痛,而不会影响止痛效果或增加不良事件.
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